Demonstrability of a serum factor inducing thrombocytosis prior to acute rises of platelets in mice and men.
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6 patients with polycythaemia vera who also developed concomitant iron deficiency are reported. When oral iron therapy was given, there was a marked reduction in the previously elevated platelet counts in 4 patients; during 2-9 years of observation of these patients there was a significant inverse relationship between haemoglobin concentration and platelet count. In the other 2 patients the elevated platelet counts did not fall when iron therapy was given. The significance of these different patterns of response in relation to the causal mechanism of elevated platelet counts in patients with polycythaemia vera is discussed.
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A thirty-eight-year-old man with primary thrombocythemia, von Recklinghausen neurofibromatosis, and myocardial-infarction-related left ventricular aneurysm with spontaneous echocardiographic contrast was followed up, suggesting that: 1. Neurofibromatosis may promote silent myocardial infarction or ischemia. Whether involvement of cardiac sensory nerves is a possible underlying mechanism remains nevertheless uncertain. 2. Platelets, whose role in the genesis of spontaneous echocardiographic contrast has been advocated, are probably not involved in this phenomenon, even in large numbers.
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Infants with Kawasaki disease are at high risk of developing life-threatening coronary complications, yet may elude timely diagnosis because they often lack the full complement of classic clinical features. We retrospectively studied 26,540 children 1 year of age or less who were evaluated at a tertiary care pediatric emergency department in whom a platelet count was performed. Among those infants with fever without a source identified, 8.5% with platelet counts of 800,000 cells/mm(3) or greater had Kawasaki disease compared to 0.4% with platelet counts of less than 800,000 cells/mm(3) (likelihood ratio for Kawasaki disease was 17 [95% confidence interval, 8-34]). Because many infants present atypically, Kawasaki disease should be considered in all children of 1 year or less with prolonged fever, extreme elevation of the platelet count, and no compelling alternative diagnosis.
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